Objective To investigate the relationship between coronary arterial dominance and the number of the vascular lesions and correlation analysis of the severity in patients with coronary artery disease (CAD).Methods From July 2010 to April 2014, 1654 CAD patients were enrolled in our hospital. According to vascular lesions involving, CAD patients were divided into the onevessel disease (n = 465), the twovessel disease (including single left coronary artery lesion) n=414) and the three-vessel disease (n=775). After adjusting age, sex, smoking history, hypertension, diabetes and hyperlipidemia, the logistic regression model was used to analyze which type of coronary artery dominance (right coronary dominance, nonright coronary dominance) was the possible risk factor for the increase of the number of coronary artery disease. Gensini score was compared to explore the relationship between coronary dominant types the severity of coronary artery disease.Results In the multivariate logistic regression model, possibility of right dominant type with threevessel disease was 1.681 times more likely than nonright dominant type (Odds Ratio ［OR］= 1.681, 95% confidence interval ［CI］, 1.096-2.579, P= 0.017), and the difference was statistically significant. However, there was no significant difference in the incidence of doublevessel disease between right dominant and nonright dominant types (OR=1.212, 95% CI, 0.781-1.880, P= 0.392). The Gensini score of right coronary dominant group was significantly higher than nonright coronary dominant group（42.3±33.6 vs 36.3±29.8，P=0.033). Conclusion Rightcoronary dominance may be an independent risk factor for threevessel disease, and rightcoronary dominance may lead to a more severity of coronary artery disease.